Abstract:
BACKGROUND:Presurgical cognitive impairment (PreCI) is frequently seen in older age, but the influence on postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) remains unclear. The present study sought to determine the association between PreCI, POD and POCD with special focus to different PreCI domains. METHODS:We analyzed 934 patients with complete baseline neurocognitive assessment. PreCI was determined as cognitive performance of at least two standard deviation (SD) below the mean performance of non-surgical controls. POD was assessed according to the Diagnostic and Statistical Manual of Mental Disorders 4 (DSM-4). POCD at three months follow-up was calculated by the reliable change index (RCI). Associations between PreCI and POD or POCD were assessed using multivariable logistic regression models adjusted for age, sex, randomization, ASA status, type of anesthesia, and type of surgery. RESULTS:PreCI was significantly associated with POD [OR 1.936 (95%CI 1.119 to 3.348); P=0.015] and POCD [OR 3.091 (95%CI 1.287 to 7.426); P=0.012]. Patients with coincident PreCI and POD were significantly more likely to develop POCD [OR 6.131 (95%CI 1.476 to 22.364); P=0.007]. Differentiation between no PreCI, amnestic and non-amnestic PreCI revealed a sole influence of amnestic PreCI on POD and POCD. CONCLUSIONS:Patients ≥ 60 years with PreCI were more likely to develop POD and POCD, respectively. The odds for POCD were highest in patients with PreCI whom also suffered from POD. Amnestic rather than non-amnestic PreCI might play a key role in the development of POD and POCD. These results warrant further pathophysiological investigations and demand preventive strategies.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Knaak C,Brockhaus WR,Spies C,Borchers F,Piper SK,Radtke FM,Lachmann Gdoi
10.23736/S0375-9393.20.13903-8subject
Has Abstractpub_date
2020-04-01 00:00:00pages
394-403issue
4eissn
0375-9393issn
1827-1596pii
S0375-9393.20.13903-8journal_volume
86pub_type
杂志文章abstract:BACKGROUND:Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) are the most common causes of severe acute brain injury in younger Intensive Care Unit (ICU) patients. Dysglycemia (abnormal peak glycemia, glycemic variability, mean glycemia, nadir glycemia) is common in these patients but its comparative outco...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.19.13307-X
更新日期:2019-08-01 00:00:00
abstract::The Authors report a case of coccygodynia following a car accident and describe the therapeutic approach used. In view of the clinical characteristics of pain and the limited quality and duration of benefits, it was proposed to insert an epidural neurostimulation electrode in an attempt to normalise the threshold of n...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1992-11-01 00:00:00
abstract:OBJECTIVES:To review experience with anaesthetic management in patients undergoing a left ventricular assist system (LVAS) Novacor implant as a bridge to cardiac transplantation. DESIGN:Retrospective clinical study. SETTING:Cardiothoracic operating room in a university hospital. PATIENTS:Nine, aged 37-62 years, suff...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Acute normovolaemic anemia (ANA) frequently occurs during cardiopulmonary bypass (CPB) and major surgeries. We investigated whether fluids (with different compositions) used to replace blood elicit any degree of systemic or lung inflammatory response. METHODS:We evaluated systemic and pulmonary inflammatory...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2013-10-01 00:00:00
abstract::Acute lung failure is associated with high mortality and usually requires mechanical ventilation to ensure adequate gas exchange. However, mechanical ventilation itself can be associated with major complications and can aggravate pre-existing lung disease, thus contributing to morbidity and mortality. Extracorporeal g...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2011-05-01 00:00:00
abstract::Thoracic trauma frequently involve damage to the cardiac structures and in the worst cases, the progressive degeneration and necrosis of the damaged tissue lead to cardiac rupture. The high mortality resulting from cardiac tamponade requires the prompt execution of diagnostic tests to provide as much useful informatio...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2000-06-01 00:00:00
abstract::Cardiac surgery patients often develop a restrictive pulmonary impairment and gas exchange abnormalities in the early postoperative period. Chest physiotherapy is routinely prescribed in order to reduce or prevent these complications. Besides early mobilization, positioning and shoulder girdle exercises, various breat...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:The majority of authors and the literature recommend sugammadex dose to be calculated according to RBW without taking fat content into consideration. Our aim was to compare the efficacy and safety of sugammadex at doses of 1.5, 2, and 4 mg/kg, calculated according to ideal body weight basis, for the reversal...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:10.23736/S0375-9393.16.11349-5
更新日期:2017-02-01 00:00:00
abstract::Results obtained with Althesin as anaesthetic in 100 patient subjected to urological surgery are presented. The continuous perfusion of Althesin gave a level of stable and flexible anaesthesia that, like the return to consciousness, was particularly appreciated by aged patients. Stress is laid on the fact that the har...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract::Non invasive ventilation (NIV) has been shown to be an effective therapy in selected patients with acute respiratory failure. Due to its benefit and relative ease of use, NIV is frequently used. In addition, the shortage and high cost of intensive care beds have prompted the use of NIV outside the intensive care unit....
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2009-07-01 00:00:00
abstract::In this paper the Authors describe the anesthetic techniques used for abdominal surgery in a 19 year-old woman with "central-core disease". This uncommon congenital neuromuscular disorder is frequently related to malignant hyperthermia syndrome. Total intravenous anesthesia with the association propofol-fentanyl was w...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract::Traumatic brain injury (TBI) is a global public health epidemic. It represents the principal cause of death and disability in individuals aged under 35 in the USA. In the subacute phase, severe TBI patients who recover consciousness go through a state of agitation and delirium. However, there is only limited research ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.18.12294-2
更新日期:2018-05-01 00:00:00
abstract::Drugs used in anesthesia do not always produce the expected neurophysiological results. By studying those cases in which the reappearance of intraoperative awareness is most common, an attempt was made to estimate how many and which levels of cerebral function could be identified. Four levels were recognised: awarenes...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1990-05-01 00:00:00
abstract::The authors review the advantages and disadvantages of general and regional anesthesia in bad clinical conditions. The purpose of this study was to evaluate the efficacy of Blended Anesthesia (association of general anesthesia with a regional technique) in 25 patients belonging to ASA classes II-III-IV, undergoing sur...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:The novel influenza A (H1N1) pandemic was associated with an epidemic of critical illness. METHODS:We describe the clinical profiles of critically ill patients with severe complications due to microbiologically confirmed pandemic influenza A (H1N1) infection admitted to a medical ICU in Monza, Italy, over a...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2011-09-01 00:00:00
abstract::Prehospital care is a fundamental element for the patient's outcome, in the field of medical and surgical emergencies. There are different strategies about it, defined "scoop and run" and "stay and play". The choice among the different strategies, in our opinion, must be well-suited to the underlying pathophysiology o...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:The goal of the present work is to describe the development and results of the pediatric epidural analgesia program at the ''Hospital Nacional de Pediatria Prof. Dr. J. P. Garrahan'' in Argentina. METHODS:Patients with thoracotomy, abdominal surgery, osteotomy, amputations or severe trauma were included in ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2007-11-01 00:00:00
abstract::It is well known that the organizational model of day surgery, concerning surgical problems defined by the literature as minor, has the aim of optimising the use of hospital resources and facilitating patients and their families, from a psychological and social point of view, by reducing hospitalisation time and the a...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2001-09-01 00:00:00
abstract::Two large phase-III prospective, multicenter, controlled, double-blind, randomized clinical trials (the PROTECT III study; the SYNAPSE study) evaluated the effectiveness of an early administration of progesterone in patients with moderate to severe traumatic brain injury (TBI). In the PROTECT III Trial, patients were ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:The effort to decrease hospital stays and to increase operating room efficacy has become an important consideration in the practice of anesthesia. METHODS:Fifty-three patients who underwent shoulder rotator cuff repair in the sitting position were divided into four groups according to the anesthesia techniq...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2001-09-01 00:00:00
abstract::The Authors, after a brief review of malignant hyperthermia (MH), describe the use of NLA a Harrington's surgical procedure in a malignant hyperthermia susceptible (MHS) patient. Such an anaesthesiological procedure, using benzodiazepines, droperidol, fentanyl, pancuronium and N2O/O2, didn't lead to any form of MH cri...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1989-09-01 00:00:00
abstract::For several years now, the need for improving healthcare quality has determined the adoption of a businesslike philosophy in American hospitals, through quality control and improvement systems. In Italy, the introduction of this business concept in public healthcare is recent, while quality assurance is still widely i...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Coronary artery bypass graft surgery with cardiopulmonary bypass induces a systemic inflammatory response. However, when thoracic epidural anaesthesia is administered as part of a combined anesthetic technique, the stress response associated with the cardiopulmonary bypass (CPB) may be attenuated. METHODS:T...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2008-11-01 00:00:00
abstract::Aspecific cellular reactivity was assessed in patients who underwent open heart surgery. The authors conclude that depressed PMN activity measured as O2- production is not linked to anaesthesiological procedures, hemodilution and hypothermia. No conclusive reports are possible on the role of pulmonary reinfusion or pl...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1989-07-01 00:00:00
abstract:OBJECTIVE:To set up an index for the evaluation of type of interventions and procedures applied a prerequisite for the evaluation of appropriateness of ICU's activity. DESIGN:Observation prospective study. PATIENTS:2507 patients out of the 5030 enrolled in the cohort study. MEASUREMENTS:A cross-sectional assessment ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1997-11-01 00:00:00
abstract::Arginine vasopressin (AVP) and its synthetic, long-acting analog terlipressin (TP) are potent alternative vasoconstrictors in the treatment of septic patients with catecholamine-refractive vasodilatatory shock. The results from one large randomized clinical trial suggest that AVP plus norepinephrine (NE) infusion is a...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:A new pulmonary artery catheter and monitor for continuous cardiac output measurement (CCO), based on thermodilution principle, has been recently developed. Aim of our study was to evaluate the new system by comparing data obtained with the CCO with the standard bolus thermodilution method (TD). METHODS:Nin...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1998-09-01 00:00:00
abstract::The etiology, diagnosis, pathology and treatment of rhabdomyolysis due to intraoperative malpositioning and the medico-legal implications of physicians involved in the surgical treatment and anesthesia of the patient are described. According to the Italian law, the anesthesiologist is the only physician of the surgery...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:Local anesthetics (LA) work by blocking sodium conductance through voltage-gated sodium channels. Complete local anesthetic resistance is infrequent, and the cause is unknown. Genetic variation in sodium channels is a potential mechanism for local anesthetic resistance. A patient with a history of inadequate...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2016-10-01 00:00:00
abstract:AIM:The aim of this study was to evaluate and compare the parameters for mechanical respiration in pediatric patients undergoing controlled ventilation with a laryngeal mask (LM) and an uncuffed orotracheal tube. METHODS:The study examined 100 ASA 1 patients undergoing general anesthesia with myoresolution and mechani...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2000-01-01 00:00:00